When general practitioners don't feel appreciated by their patients: prospective effects on well-being and work-family conflict in a Swiss Longitudinal Study

Background: Impaired well-being and high work-family conflict are critical issues among GPs. This research examined an understudied psychosocial risk factor for these outcomes, namely GPs' perception that they invest more in the relationship with their patients than what they receive in return (i.e. lack of reward in their relationship with patients). Objective: To test the effect of lack of reward as a risk factor for poor well-being and work-family conflict among GPs. Methods: Longitudinal study (12 months time lag). 272 GPs in Switzerland [mean age 54.5 (SD = 8.3), 73% male] volunteered to participate in the study. 270 participants completed the baseline survey and 252 completed the follow-up survey. Of these, six retired between the baseline and the follow-up survey, resulting in a sample size of 246 participants at t2. Outcome measures were burnout, sleep problems, self-perceived health and work-family conflict. Results: Strength and direction of prospective effects were tested using cross-lagged models. Lack of reward was related to an increase in emotional exhaustion (beta = 0.15), sleep problems (beta = 0.16) and work-family conflict (beta = 0.19) and a decrease in self-perceived health (beta = -0.17). Effects on depersonalization and personal accomplishment were not significant. Regarding reversed effects of impaired well-being on lack of reward, emotional exhaustion (beta = 0.14) and self-perceived health (beta = -0.13) predicted future level of lack of reward. Conclusion: Lack of reward by patients is a risk factor in GPs' mental health.